In a typical I.V. catheter insertion procedure, the I.V. catheter is inserted into a patient after preparation and sterilization of the insertion or wound site. Thereafter, the catheter is held in place by a plurality of tapes which are typically torn from a roll of surgical tape. The first tape is typically or preferably twisted around the catheter in a butterfly-like fashion and subsequent strips are then torn from the roll and applied to the ends of the butterfly tape and over the catheter to hold it in place. Often, an adhesive patch, or wound barrier, is applied directly over the catheter, with tape strips subsequently used to additionally secure the catheter. This typical procedure has a number of disadvantages.
Since the tape is not applied until after the catheter is inserted into the vein and, since the tape is typically torn from tape rolls, it is clear that the technician must frequently let go or release the catheter so that both hands can be used for the taping operation. This catheter release is required to either tear the strips from the roll of tape or, in the alternative, for the removal of pre-torn strips and their placement around the catheter. Any time the catheter is released after it has been inserted, it is in danger of falling out, thus requiring a reinsertion, at the least.
In one typical mode of operation then, a technician will tear off a number of tape strips and place them on the bed rail, on the bedside cabinet, or some other structure. These surfaces are mostly non-sterile.
After the insertion of the catheter, the technician still must use two hands in forming the strip around the catheter, particularly where a butterfly wrap is used, and the catheter is then in danger of falling out when not held in place during the use of both hands to handle the tape. The use of both hands in tearing off the tape and placing it on a non-sterile surface introduces the possibility of contamination of the underside of the tape, resulting in a non-sterile application. Moreover, because the tape must be torn and because it is much easier to tear the tape with an ungloved hand, frequently technicians will carry out at least this part of the procedure without using gloves at all. Use of bare or ungloved hands presents contamination problems to both patients and technicians. Additionally, potential contamination may arise from placing tape strips on non-sterile surfaces such as bed rails or cabinets just prior to their application to the patient.
A second problem that arises from this typical method, apart from the problems incurred with taping, concerns needle disposal. Following the insertion of an I.V. catheter into a patient, the needle used for the catheter insertion is removed, leaving the catheter in the patient's vein. The technician involved in inserting the catheter must now dispose of a contaminated needle, all the while maintaining pressure on the I.V. wound site so the catheter does not become loose and/or fall out before taping. This increases the difficulty of disposal of the needle, and often results in the contaminated needle being placed on a table tray or other surface near the area where the technician is at work securing the catheter. There, it has the potential to inadvertently puncture and infect other persons such as hospital personnel, the patient, family members or others. This also increases the chances that the contaminated needle may be lost prior to disposal and therefore pose an ongoing risk to other persons. Since the technician cannot usually release pressure on the catheter to take the needle to a disposal unit (which may be across the room or the like), disposal of the needle may be effected by bringing a disposal unit to the technician. This results in a disposal unit containing several contaminated articles being brought into close proximity with the patient, and is undesirable.
Another problem with the typical method of reinserting the needle in the protection sheath prior to its disposal is that the technician must hold the sheath in one hand while placing the used needle inside with the other hand. This brings the needle into very close proximity with the skin of the sheath-holding hand of the technician and constitutes risk of an inadvertent "stick" or puncture with a contaminated needle. All of the above problems increase the opportunities for either patient, technician or others to become infected. It has been estimated that each year, almost two million individuals who enter hospitals in this country acquire infections they did not have when they went there, and of these, eighty thousand die. (Jeffrey A. Fisher, The Plague Makers; NY: Simon & Schuster, 1994).
Accordingly, and in view of the above background, there is a need for a sterile I.V. catheter securing system and/or for a needle disposal system which overcomes at least some of the problems noted above. It is also desirable to provide a system to facilitate the sterile handling of sterile wound barriers and tape strips. It is also desirable to provide a system which allows for the safe disposal of contaminated needles.